妊高征患者心输出量与总外周血管阻力分型的多普勒超声研究

Classification of Cardiac Output and Total Peripheral Vascular Resistance in Pregnancy-induced Hypertension by Doppler Ultrasonography

目的 利用多普勒超声检测手段观察妊高征患者血液动力学特征。方法 临床诊断为重度妊高征(PIH)患者 (均为先兆子痫 ) 32例 ,正常妊娠 (NP) 2 4例 ,通过主动脉瓣环处内径及血流频谱计算心输出量及心指数 ;计算总外周血管阻力及其指数 ;取受检者右中指动脉血流频谱 ,测量记录各种血流参数。结果 本组PIH患者总外周血管阻力指数显著高于正常NP组 (989 75± 96 0 2dyn·s·cm-5/m2 vs 6 6 7 37± 76 0 5dyn·s·cm-5/m2 ,P <0 0 5 ) ;心指数与NP组无显著差别 (3 92± 0 93L/min/m2 vs 4 0 0± 0 6 0L/min/m2 ,P >0 0 5 )。PIH患者血液动力学类型主要有 :低排高阻型 (占 46 9% )、正常排高阻型 (占 15 6 % )、高排低阻型 (占 12 5 % )及高排高阻型 (占 9 4% ) ,此外还有正常阻力型。指动脉血管阻力指数与总外周血管阻力指数无明确相关性。结论 PIH患者血液动力学模式复杂多样 ,总外周血管阻力较外周细小动脉阻力更能反映PIH患者的血液动力学特点。

Purpose To investigate the maternal hemodynamic characteristics in pregnancy-induced hypertension (PIH) by means of Doppler ultrasonography. Methods Thirty-two PIH patients and 24 normal pregnant (NP) women were enrolled in this study.Cardiac output was calculated by Doppler echocardiogrphy at aortic loop.The corresponding total peripheral vascular resistance index (TPVRI) was also calculated.The right mid finger artery's spectrum was also recorded with ultrasonography. Results The PIH patients had much higher TPVRI than those of the control group (989 75±96 02 dyn·s·cm -5 /m 2 vs 667 37±76 05 dyn·s·cm -5 /m 2, P <0 05) and there was no significant difference in CI between the two groups (3 92±0 93 L/min/m 2 vs 4 00±0 60 L/min/m 2, P >0 05).The PIH patients' hemodynamics was mainly divided into following types:low CI with high TPVRI (46 9%),normal CI with high TPVRI (15 6%),high CI with low TPVRI(12 5%),and high CI with high TPVRI (9 4%) and other types. Conclusion The PIH patients have different hemodynamic profiles and TPVRI could be a better indication of PIH hemodynamic changes than the finger arterial Doppler parameters. [